Oxycontin vs Oxycodone

Oxycodone is the active ingredient of both Oxycontin and oxycodone, and at first glance it may seem like they are interchangeable as prescription opioids for pain management.  I’ve posted about this before in an article titled, Oxycontin: What’s the Big Deal? A comment recently stating, “The big deal is that people are dying and going to jail every day because of untreated addiction to prescribed medication.” brought this issue back to the front of my mind.

Oxycodone is the active ingredient in many prescription pain meds, including Perocet, Tylox as well as the single ingredient generic oxycodone.  It is also the active ingredient in the combination immediate and time release Oxycontin.  The problem with Oxycontin is that a large percentage of the oxycodone is immediately released, while the rest is released over time.  The purpose of this is to give immediate relief of pain, while keeping pain controlled over time with the delayed absorption of part of the medication.  Unfortunately the large percentage released immediately of this particular opioid which has a higher euphoria effect than most opioids makes it a very popular drug of abuse, and even used appropriately it has a high incidence of addiction.

This has resulted in the development of a whole sub-culture of Oxycontin abuse.  It’s become known as Hillbilly Heroin or just oxy on the streets.  Oxycontin is very commonly pulverized into a powder to void the delayed release effect, and ingested, injected, snorted, or inhaled.  Smoking Oxycontin has become a common problem in some areas of the country.  Oxycontin is arguable the most abused opioid in the US.  It is a drug of choice for many prescription opioid addicts and the Oxycontin side effects can be severe.  It has little if any advantage over alternative opioids and is generally best avoided in non-malignant terminal pain patients.

Although physicians have come under a great deal of criticism, sometimes appropriately for excessive prescription of opioids, especially Oxycontin, we have also come under criticism for inadequate treatment of chronic pain.  Recommendations for obtaining expert consultation when prescribing long term opioids sound fine at face value, but at least in the community where I work it is nearly impossible to find such an expert for consultion.

In the last two months I’ve had two young male patients present to the office for help with Oxycontin addiction.  Neither of them had ever received a prescription for Oxycontin from a health care provider.  Both had been given the drug by a friend at their work.  One was trying the med to help with a nagging back ache, another just to see how he liked using the drug.  Both told me they quickly became physically and psychologically addicted within a couple of weeks.

In my community it drug seeking patients have become such a problem that many chronic pain patient can’t find a doctor to prescribe pain meds.  Physicians who become known as willing to take new patients for chronic pain medication management are quickly targeted by both patients with serious medical problems with pain medication requirements and by the drug seeking abusers.  This reputation can quickly make a practice unpleasant and put the physician at risk for sanctions by their state review board.

Look at Oxycodone side effects for another great resource and thanks for reading this medical blog.  Leave a comment and contribute to the discussion about Oxycontin versus Oxycodone below in the proper field.

22 Responses to Oxycontin vs Oxycodone

  1. Kari: You are blessed to have a physician whom you trust and find helpful. It sounds like a med change was in order and the oxycontin is a reasonable option. Stay in touch with your physician and I hope this helps you. DrP.

  2. I have been on Morphine extended release 15mg 3x day and oxycodone 15mg 4x day as needed for about 2 years for chronic moderate to severe back pain. I have been seeing a very reputable pain management doctor for over 4 years. She has also been giving me lumbar, thoracic, and cervical injections every 3 months for over 4 years as well. She does everything strictly by the books. You have to have random drug screens about 4 times a year and you have to see her in her office at least every 2 months. She is a very compassionate doctor and cares about your overall health and you as a person. Not just getting you in there and out and collecting a copay.
    This past June I had a spinal cord stimulator put in after she did a trial one on me a few months prior to that. I could tell it helped a great deal with my pain so I decided to go forward with the permanent one. It does help immensely but at time the pain is so severe, even the stimulator doesn’t help. Today I saw her and she decided she would changed my meds. She dropped the morphine and added OxyContin extended release 20mg every 12 hours and left the oxycodone 15mg 4x day as needed. I also take Xanax, temazapam, and cyclobenzaprine at bedtime. (Which she is well aware of.) Is all of this going to be safe to take together? I can’t take anything with acetaminophen because I have had high liver enzymes in the past. I have to keep that under control and was told to take nothing with acetaminophen in it. This seems like a lot of very strong medication to take at the same time. I was feeling like I was building up a tolerance to the morphine/oxycodone combo. It just wasn’t working very well anymore and my pain level seems to have gotten much worse. I have total faith in my doctor, don’t get me wrong. She has been so great over the past years that I have been going to her. I just wanted to get a few other opinions about this medication combination. I’m not worried about becoming addicted. It has been my experience that people who get addicted are usually the ones that are looking for a high in the first place, don’t really need the medicine because they aren’t in that much pain, and don’t take the medicine as prescribed. If you are truly in pain, take your medicine like it is prescribed, then you won’t feel a high because the meds will only be doing its job of taking your pain away. Their wont be enough strength in them to give you a high.
    I just hope this combo she has prescribed for me will do the trick. I haven’t been able to sleep a decent nights sleep in over 3 weeks. I wake up feeling like I’ve been thrown against a brick wall several times then left to sleep on cold concrete all night. I’ve been missing a lot of work, and I only work 20 hours of work as it is! Something has got to give!!! 🙁

  3. I have taken 30 mg oxycodone 6 times a day for several years for severe burning pain in my hands from nueropathy. Now my doctor wants me to go to fentanyl patches. Everything I read about Fentanyl scares me. [Recalls, clasas action lawsuits, dangers from getting the drug on fingers] I don’t know what to do. I have never had a problem from oxy.

  4. I have been on pain meds for four years, started with a hip replacement that led to spinal issues, ultimately a fusion that failed to solve it. I started with Percocet for a couple years, then Roxicodone for the last two years. This is for pain only, I am not an abuser and have no interest in getting high from it. Recently, due to the time between the last dose of Roxicodone being about 9pm, by morning I am in withdrawal with sweats and pain. My PCP switched me to 30mg OxyContin twice a day this week. So far,so good. The pain does still sneak in , but I feel nothing otherwise. I have high hopes. My big concern has been all the hype about abuse.
    My doc says he will be required to do a urine test occasionally but i am fine with that. I have always had some wine in he evenings with no adverse effects, since this drug the the same dosage of the same chemical, I expect to see no problems as I am quite opiod tolerant after four years.

  5. I have taken the various narcotic pain meds for back and hip pain, and they all have different side effects for me. Even though Percocet and Oxycontin contain oxycodone, Percocet gives me a horrible headache that can last 24 hrs as well as intense nausea, whereas Oxycontin does not. For the same reason I cannot take Norco or Vicodin, but codeine works fine with no side effects. I also found that codeine from Europe and South Africa (where you can buy it over the counter) works better than the American stuff. Has anyone else had a similar experience?

  6. Hello, I have been taking oxycontin since it first came out. I have FM, 3 neck surgeries (chronic pain always there), diabetes and just this week diagnosed with arthritis in hips, knees hands and other areas. In the hips, hand and knees I have bone spurs and other problems. I am a 67 yr old woman who has always been active, own my own business that is almost impossible to keep up. There is Fibromyalgia in my family and my grandmother was in such pain that she took her own life.
    Oxycontin has worked for me, I have no feelings of euphoria but if I forget to take my medication it is very painful (burning pain). I have been told that people who need pain med are not addicted but dependent on these meds; sometimes I think this is playing with words but since I would not have any life unless I could take this pain med. it is a mute point. Yes, I am scared of what they are doing to Drs. and Patients (government regs are terrible)

    Just last month I saw my Rheumatologist, he is new to me as my long time doctor just retired, this doctor is in the same clinic but does not know me. He gave me a Urine Tox test and I was shocked to get the results: Negative! I have no idea how I could have a result like that when I take 20 mg 3 times a day and pretty much have been on that dose for most of the years. Once in awhile I take the dose down for awhile to clean my system out and then restart my regular prescribed dose. My retired doctor told me I was doing the right thing and he said he did not think I could go without a pain med. Sometimes I wish that I could be normal and stop taking them but the quality of life is not worth it. To tell you the truth…the climate of today’s Press, government and very scared doctors is scaring me and it makes me feel like I have to prove myself….those of us that are living in terrible pain are being brutalized by those who has no idea of what it is like to have pain and the government that is encroaching on all areas of our life.
    I have done some reading about the false negative test and why it may have come out like it did but very surprised that doctors and other professionals in the health care system are not aware of the oxycontin type meds and how they often read “Neg”. See the link above. I don’t know if you have read this article, if not I believe you would be happy you did. I would like to know what your thoughts are if you do read it. I would also like to know what alternatives pain sufferers have to turn to. I also read that Oxycontin is one of the meds that do not have negative effects on the liver, kidneys and other organs.
    I have no doubt that going off Oxycontin and like drugs would be hard but doable…I doubt life would be very good in the kinds of pain many would have so what have you to say about our choices?
    Thanks in advance for your comments.
    Phomp North Idaho

  7. Joan: There are many opioids. Codeine is one of the natural opiates from the poppy resin Synthetic opioids are derived from the opiates, and are in the same family, work on the same receptor in the brain and elsewhere. Oxycodone is the opioid that is the active component in many drug formulations including Percocet, Tylox, Roxicet, Oxycodone, Oxycodone and others. Oxycontin is a brand name sustained release formulation with the active ingredient oxycodone. Hope this helps. DrP.

  8. I still don’t understand which drug is which. I don’t think I’ve been on either one, but now I’m not sure. I am sure I’ve never been on Oxycontin.I just don’t know if it’s the same thing as Oxycodone.
    I think my breakthru meds are Oxycodone ? But normally, I take methadone for pain.
    People are telling me that neither one is codeine. Is it ?
    They’ll say they can’t take codeine, but then they say they are on Oxy. So what are they doing ?

  9. To all,(especially Jason) I am NOT a physician but I have used oxycontin for intractable back pain. It is my experience and belief that if you are truly seeking relief, and do NOT have an addictive or thrill seeking personality, the use of this (or any other analgesic or narcotic within this paradigm is NOT addictive. You must KNOW yourself and use it/them ONLY for pain control, and wean yourself off as you can. However, if your pain will NOT allow weaning, continued use will not result in addiction, UNLESS YOU INTEND to do so. It is my studied belief that your pain will metalbolize the narcotic to eliminate the pain. So, if you do not increase your dose beyond that NECESSARY to control your pain, and titrate down as possible, ADDICTION will not be a problem for you.

  10. Oxycodone is both God and the devil. I’ve had nerve damage from a surgery I had in the Marine Corps and wicked bad back pain from a boating accident for the last 5 years. My VA doc has been giving me Oxy 15mg to help manage the pain. Everything was going fine until my gf showed me that I could crush and snort them. She gets 30mg from her fox for a nasty car accident she had that took 3 of her fingers and severely screwed up her arm. For some reason, now that I snort them I find myself taking Way more than I should. Because my gf and I get the same meds, we share our scripts. When we run out and have to go through detox, we want to kill each other. When we have them, we are on cloud nine. I’m so sick of this rollercoaster. It isn’t so much a mental addiction as it is a physical dependency. The only way to make ourselves feel better when in detox is to take one or two. It feels like a never ending circle. I recommend to anyone who has pain to find other means of management. Even the strongest of minds become weak when Oxy is introduced. It Will get rid of any and all pain but the risk is not worth it. I’ve been off of them for about a month now and feel fantastic. I don’t care if I get my feet cut off in a car wreck, I never want to see another one of those pills again.

  11. I have rheaumatoid arthritis i have severe pain in all my joints my r.a. doctor did not not want to give me anything for the pain because he was scared of all these dumb people who get addicted and recieve these drugs on the streets and ruin it for those of us who are in real pain and actually need this medicine then my p.c.p. gave me norco it helps and i do not feel i need to have it if i do not take it only take when i am in a lot of pain

  12. Sam, as a person that uses pain meds for pain (for 14 years now), I want you to know that you CAN do it by yourself. You have to be willing to go through your withdraw. It is short lived, although it doesn’t feel like it is. Depending on how bad your withdraw is, you may want to keep an eye on your blood pressure. You can buy a blood pressure cuff, or you can daily check it at your local drug store. I am not a doctor, these are just suggestions. I am very educated on the matter because of my medical problems. I myself am able to consiounsly identify when I am abusing them. Years ago I made the choice to be aware of my abuse. I now tell my husband that he needs to hold onto them and when I feel I need one I simply ask him. He decides from there if I really do or not. Because, when you are addicted you are unable to make the SMART decision whether you need them or not. Also, I want to add that a lot of addiction and withdraw (in my oppinion)is a mindframe or frame of mind. Alow yourself to BELIEVE you will be better. Alow yourself to believe the Adivan helps you. Take deep breathes from your stomach and just relax. Think of your favorite place or your favorite memory. I’m saddened by the story of the husband that won’t get help (the guy with the shoulder surgery). One of the reasons I made the choice to control my medicine is my husband. I didn’t want to be that kind of wife to him. Or that kind of child to my parents.

  13. Connie: Oxycodone is the ingredient in Oxycontin. I have way to comment on how you are doing of course. As you know all opioids lead to physical tolerance and withdrawal issues. DrP.

  14. I take Oxycodone as needed for pain relief along with a 50 mcg Fentynal patch every two days. I never feel high or addicted. My sister hears such terrible news about Oxycontin & is worried for me. I tell her it’s not the same…I’m correct, right?

  15. I don’t understand how people get addicted to this stuff. I have been on a script for over a year, taking 40mg of oxycodone + 40mg of hydrocodone. When I take a few days off the medications all I feel is the pain from my injury, not whole body aches, no sweating, no flinching, no fever, just pain associated with the injuries. Maybe its different for people who take it without high levels of pain, but I never crave this medicine. All it does is take the edge off pain. In fact it doesn’t even bring anywhere near 100% relief. I don’t get buzzed or high either. I have not taken oxycontin though I have been offered it from my doctor. These stories scare the crap out of me and once workers compensation approves my surgery I have a security sensitive job to get back to (pilot). So, out of fear of the contin medications I am in constant pain… If I could find the truth about the medication I might be willing to get that much needed relief. I was hoping to find data to correlate people with addiction problems having issues with oxycontin or is it everybody. If I am not addicted to codone, will contin be THAT much different? Im not looking for more pain later down the road – so if its really THAT bad I rather just have the physical pain that keeps me from enjoying life, sleep, think, etc etc than the pain of hardcore withdrawal and addiction. I don’t need that in my life. Is there a valid use for this medication at all? All I keep hearing is how bad these meds are – and its keeping me from having any lasting comfort (beyond 20 minutes per dose).

  16. Marie: Maybe she can enlist his physician to encourage him to get him off the med if he is getting prescriptions. If he is buying illicit pills it will be harder. Good luck. DrP.

  17. My friends husband has been on oxycodone for many years, he was prescribed it initially for pain relief after reconstructive surgery of his shoulders. His energy level is down substantially and has very little motivation. He is down on himself, constantly dwelling on “how he used to be”, physically. His wife doesn’t know what to do anymore, ultimately she would like to get him into treatment, but he is not willing. He knows this drug is bad for him but he won’t do anything about it. He gets dizzy and falls, hurting himself almost everytime, he does embarassing things infront of her friends and she’s tired of it. What can be done? Treatment facilities won’t take him unless he is willing, he won’t listen to her about alternate pain relief. She feels pretty helpless and doesn’t like watching her husband slowly kill himself, what can she do?

  18. Sam: These are the issues with opioid withdrawal, and you will need to either tough it through these symptoms at home, discuss a slower taper with your doctor, or get to a detox unit for help with detox. A difficult spot. DrP.

  19. I need help!!!
    I was given it for the first time about nine months ago for a chronic back pain and have been taking 20 mg of it a day. It used to help the pain but it doesn’t any more. I feel I need it during the day since I have no energy without it. I hate it and have tried to stop it twice. First time I tried to simply stop it and it was a disaster. First night was hard but I held on but on the second night I felt like I was dying. The physical withdrawal symptoms were so strong and the pain in my arms and legs together with the jerking in my body was so bad that made me give in and take a 10 mg of it and they all went away. SO I went to see a doctor for it and he gave me a few Ativan, muscle relaxant, and antihistamine to take the night I try. But again things were not different from first time… I finally couldn’t take it anymore and my wife was about to call paramedics as I was going through it. I need real help with it and don’t know what else to do. If anyone knows a way, please help.

  20. Sam- I hear your anguish. This is a very addictive drug. Detox and rehab is the only approach I know of to recommend. See your primary care physician for referral help.

  21. I am addicted to oxycontin and oxycodone (codone is immediate release and far more sought after). I use it for pain but I also use it for pleasure. I have gone through withdrawal to stop and it was horrific. Never thought I`d do them again. But now I know that I withdrew so that I would be able to start taking them again and experience the high again on less of a dose. I want OFF! permanently and dont know how to do it.

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